Health literacy and promotion strategies among the elderly populations / 预防医学

Abstract@#The aging process is increasingly accelerating in China, and the improvement of health literacy is a prerequisite to achieving health for all, and is an important strategy to promote healthy aging. Based on recent studies pertaining to health literacy among the elderly, this review, from the perspective of aging, summarizes the level and common influencing factors of health literacy among Chinese elderly populations, and discusses the health literacy promotion strategies among the elderly, so as to provide insights into improving the health literacy surveillance and promotion quality and health literacy levels among the elderly.

Undercover investigation on the smoke-free environment in medical and healthcare institutions in Zhejiang Province / 预防医学

Objective @#To investigate the establishment of smoke-free environments in medical and healthcare institutions in Zhejiang Province, so as to provide the evidence for improving the implementation of the tobacco control policy in medical and healthcare institutions.@*Methods@#Health administrative sectors and public health institutions at provincial, city and county levels, secondary and tertiary medical institutions, and community health service/township health centers in Zhejiang Province were enrolled. The status of institutional establishment of smoke-free environments was investigated through concealed photography and consulting medical service guides by the assigned the third-party professional investigation company in 2021. The layout of smoke-free environments and indoor smoking were assessed according to the Criteria for Scoring Smoking-free Medical and Healthcare Institutions.@*Results@#Totally 547 medical and healthcare institutions were enrolled in this undercover investigation, including 102 health administrative sectors, 209 public health institutions, 146 secondary and tertiary medical institutions, and 90 community health service/township health centers. The gross mean scores of establishment of smoke-free environments were 83.41±12.19 among all medical and healthcare institutions, 82.02±10.73, 85.56±9.70 and 83.18±12.59 among province-, city- and county-level medical and healthcare institutions, respectively, and the gross mean scores of establishment of smoke-free environments were 82.60±12.27, 85.79±10.74, 80.89±13.85, 82.27±11.62 scores among health administrative sectors, public health institutions, secondary and tertiary medical institutions and community health service/township health centers, respectively. There were 315 institutions with no smoking signs at entrances (57.59%), 255 institutions posting no smoking signs ( 46.62% ), 245 institutions assigning two and more types of health education materials for tobacco control ( 44.79% ), 110 institutions with outdoor smoking areas ( 51.16% ), 66 secondary and tertiary medical institutions with smoking cessation clinics ( 45.20% ) and 354 institutions with carpet smoking bans in indoor places ( 64.72% ).@*Conclusions@#The overall establishment of smoke-free environments is satisfactory among medical and healthcare institutions in Zhejiang Province. Nevertheless, improving the coverage of no smoking signs and health education of tobacco control, promoting the standardized construction of smoking cessation clinics and establishing a long-action tobacco control mechanism are still needed.

Current status of cigarette and electronic cigarette use among adults in Zhejiang Province / 预防医学

Objective@#To investigate the prevalence of cigarette and electronic cigarette ( e-cigarette ) use among adults in Zhejiang Province, so as to provide insights into tobacco control. @*Methods @#Thirty study sites were randomly sampled from Zhejiang Province in 2020 using a multi-stage stratified random sampling method, and permanent residents at ages of 15 to 69 years were selected as study subjects. A questionnaire was designed based on the questionnaire for the China Adult Tobacco Survey to collect subjects' demographic characteristics, cigarette and e-cigarette use, smoking cessation and exposure to secondhand smoke ( SHS ). The weighted prevalence of smoking, current smoking, current e-cigarette smoking, smoking cessation and exposure to SHS was estimated based on the Seventh National Population Census in 2020.@*Results @#A total of 19 200 questionnaires were recovered, and 19 180 were valid, with an effective recovery rate of 99.90%. The respondents had a mean age of ( 50.30±12.90 ) years, with a male to female ratio of 1∶1.06 and an urban/rural population ratio of 1∶1.31. Among all the respondents, there were 6 033 smokers ( 31.45% ), 4 163 current smokers ( 21.70% ), 201 current e-cigarette users ( 1.05% ), 146 cigarette and e-cigarette dual users ( 0.76% ), 1 870 respondents quitting smoking ( 31.00% of smokers ) and 7 189 respondents with exposure to SHS ( 47.87% of non-smokers ). The weighted prevalence of smoking, current e-cigarette use, cigarette and e-cigarette dual uses, smoking cessation and exposure to SHS was 20.49%, 1.34%, 0.94%, 29.56% and 49.53% in Zhejiang Province, respectively, and the prevalence of current smoking, current e-cigarette use, cigarette and e-cigarette dual uses and exposure to SHS was 40.39%, 2.39%, 1.86% and 55.31% among males and 0.35%, 0.28%, <0.01% and 46.02% among females, respectively. The highest prevalence of current smoking was seen among respondents at ages of 55 to 64 years ( 24.24% ), while the highest prevalence of current e-cigarette use and cigarette and e-cigarette dual uses was seen in adults at ages of 25 to 34 years ( 2.18% and 1.58% ).@*Conclusions @#The prevalence of current e-cigarette use was higher among adults in Zhejiang Province in 2020 than the nationwide level in China. The prevalence of cigarette use was lower among adults in Zhejiang Province in 2020 than the nationwide level in China; however, improving the management of tobacco control in public places and the capacity building of smoking cessation services is still required to reduce the use of cigarettes and e-cigarettes.

Review of advance in health impact assessment / 预防医学

@#Health impact assessment（HIA）is an evidence-based methodology to assess the potential impacts of a policy,program or project and to make recommendations for health improvement. HIA can promote the cooperation between health and non-health sectors,raise the awareness about health in decision-makers,increase the participation of stakeholders and change health inequality. This paper reviews the international studies into HIA from 2000 to 2018,providing reference for HIA development in China.

Human resource development of CDCs in Zhejiang Province / 预防医学

Objective@#To learn the human resource development of provincial,municipal and county-level centers for disease control and prevention（CDCs）in Zhejiang Province from 2010 to 2017,and to provide evidence for optimizing human resource allocation .@*Methods@#We obtained the human resource data of CDCs in Zhejiang Province from national information system for disease control and prevention,and analyzed the changes in the number of permanent staffs,the number of permanent staffs per ten thousand permanent residents as well as the composition of the age,education level,professional background and title in provincial,municipal and county-level CDCs from 2010 to 2017 .@*Results@#The number of the permanent staffs of CDCs in Zhejiang Province increased from 4 592 to 4 835 from 2010 to 2017. In 2017,the number of permanent staffs in overall,provincial,municipal and county-level CDCs per ten thousand permanent residents were 0.855,0.068,0.186 and 0.600,respectively,all of which did not meet the standard. The main age group of CDC staffs changed from 25-34 years old in 2010 to 35-44 years old in 2017. The staffs of overall,provincial,municipal and county-level CDCs mainly had Bachelor's degrees in 2010,while the staffs of provincial CDCs mainly had Master's degrees and above in 2017. The percentages of staffs who had Bachelor's degrees and above in overall,provincial,municipal and county-level CDCs in 2017 increased to 75.12%,90.36%,80.76% and 71.65%,respectively. The CDC staffs were mainly public health professionals,and the percentage increased from 2010 to 2017. The percentages of public health and laboratory medicine professionals in overall,provincial,municipal and county-level CDCs in 2017 increased to 71.56%,79.17%,70.14% and 71.15%,respectively. The CDC staffs mainly had intermediate title,and the percentage of senior title in overall,provincial,municipal and county-level CDCs in 2017 increased to 25.58%,38.80%,32.99% and 21.79%,respectively .@*Conclusion@#From 2010 to 2017,the structure of education level,professional background and title of CDC staffs in Zhejiang Province were further optimized,but there was a lack of permanent staffs and a decrease in the staffs under 35 years old.

STUDY OF RENAL MICROCIRCULATION IN RABBIT WITH GLYCEROL-INDUCED ACUTE RENAL FAILURE / 解放军医学杂志

This paper reports a study of renal microcirculation in rabbits with glycerol-induced acute renal failure by using the microsphere technique, transmission and scanning electron-microscopy as well as morphemetry. In the initial phase of acute renal failure, there was microcir-culatory ischemia, and the changes were parallel with functional changes following glycerol injection, the renal microcirculation showed marked structureal changes. The results indicated that renal microcirculation should be given early.